One In Five Children Who Contract Diphtheria Die – Are Anti-Vaccination Activists Dangerous, Or Simply Misinformed?

vaccine1I had the pleasure of speaking in the plenary session at the 2014 AAVLD/USAHA Annual Meeting this week, where, among other topics, we discussed risk. One of the other panelists made the best point that I’ve heard in a long time – activists hate denominators.

Think about the last few scare stories you’ve seen – there’s no doubt that it is frightening to read that 3,000 people die from food poisoning each year, or that, to date, 4,546 people have died from Ebola (one in the USA). Yet if we put this into context, one person out of 315 million in the USA dying from Ebola is a tiny tiny fraction, and a correspondingly tiny risk.

Activists hate denominators because they provide us with context, a way to assess whether we’re really in danger. Statistically speaking, you’re  more likely to die from a traffic accident (one in 71 deaths), flu (one in 1,642 deaths), or syphilis (one in 55,866 deaths) than Ebola (one in 2,515,458 deaths). Which brings me to my current favorite activist, anti-vaccine zealot and proponent of “well-researched” bad science, Modern Alternative Mama (MAM). Thus week, she’s been promoting what she optimistically calls a “risk:benefit analysis” of the DTaP (diphtheria, tetanus and pertussis) vaccine.

Interestingly, she appears to consider all vaccine risks equal: death is no more of a minor inconvenience than redness at an injection site, and she earnestly notes that there is “no known benefit to getting diphtheria“. That sentence alone causes the mind to boggle. On a positive note, she does use valid CDC data, reporting that there were 3,169 adverse effects attributed to DTaP in 2011, which she claims is an underestimate of up to 9-fold.

So let’s run the numbers. Each year, approximately 3.95 million babies are born, of which 82.5% are given the DTaP vaccine. Between birth and 6 years of age, 5 doses of DTaP are recommended, so each year, 5 x 3.95 million x 82.5% = 16,293,750 doses are given (note that babies will have three each in that year, but older children (18 months and 4-6 years) will also receive a dose). Let’s give MAM the benefit of the doubt and assume adverse vaccine events are actually 5x the cited CDC number, at 15,845 events. The CDC classifies 10% of these events as “serious”, which equals 1,585 serious events per year.

So what is your child’s chance of having a serious reaction to the DTaP vaccine? 1,585/16,293,750 = 0.0000973, or one in 10,277 children will have a serious reaction to DTaP.

By contrast, we could take our chances in not vaccinating and hope that our child doesn’t contract diphtheria, which carries a risk of death of up to 20% in children under five years old. That means one in five children who contract diphtheria will die.

Given MAM’s antagonism towards vaccines, it’s not altogether surprising that she concludes “Although diphtheria is serious, it appears that the risk from the vaccine is much greater.” Yet let’s be realistic about this. One in 10,277 children will have a serious reaction to DTaP (serious reactions does not mean death, although that is one possible outcome) versus one in five children who will die after contracting diphtheria.

Admittedly that’s assuming that all unvaccinated children will get diphtheria. They won’t, but even if only 5% do, the risk is still overwhelmingly lower in the vaccine category (one in 10,277 suffering a serious reaction to the vaccine vs. one in 100 dying from diphtheria).

The site carries a disclaimer that writers are neither education professionals nor providing medical advice, yet the suggestion (by the author herself) that this is a well-researched, scientific post will no doubt cause some parents to congratulate themselves on their choice to not vaccinate.

This pseudoscientific scaremongering is dangerous, potentially lethal. All parents are concerned for their children’s health and welfare, but propounding nonsensical “risk:benefit analyses” that do not consider the denominator but simply the total adverse effects does not allow any parent to make a rational and well-considered decision. If my child is the one in 10,277 who suffers a serious DTaP vaccine reaction, I’m unlikely to care whether she is one of few or many, but at least I can make the decision whether or not to vaccinate (my answer is an overwhelming “yes”) based on risk. We all want our babies to grow up healthy and happy – in this case, it’s time to be a mainstream vaccinating Mama, rather than a “modern alternative” one.

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Hyperbole, Hysteria, and a Sample Size of One – Where’s the Science?

IMG_9219I often describe this blog as a place where I write about things that irritate me. Today, is a case in point. There’s a new princess of technology paranoia on the block: move over Jenny McCarthy, because Modern Alternative Mama (MAM) is out to smother your crown with homemade liver pills and tweak it off your head. Billed as “a community of supportive people and well-researched information” the site is full of useful hints and tips on how to keep your children healthy – which in this case means unvaccinated, with unbrushed teeth and breast milk squirted up their noses to cure congestion. I wish this were my hyperbole – it’s not.

One of the common themes in the litany of anti-vaccination posts is the fact that vaccine scientists need funding to do experiments  (gasp!) and that such funding comes from companies that manufacture vaccines (gasp!). Obviously these scientists are the epitome of corporate shilldom and would sell their first-born child for a microscope and box of latex gloves. Best not to trust their pesky peer-reviewed science.

Don’t worry though, MAM is here to do the research for you and write about in a balanced and fair way. This translates roughly as: “Science (pesky corporate shills) shows there is no harmful effect of X, but if you allow the dastardly medical profession to force it on your defenseless bundle of joy they have a 756% increased risk of <insert scary disease here>, will be in therapy (blaming YOU) till they’re 45, and will never pass third-grade algebra. Oh, and did we mention that X has been linked to leukemia/childhood obesity/autism/type II diabetes/ADD/teenage pregnancy/atheism/voting Republican (delete as appropriate)“. They helpfully highlight the scary messages on the website in bold, so that you don’t miss them.

As with so many anti-technology sites, science is the enemy…unless it’s happy touchy feely science that backs up whatever theory is being propounded this week. Which is why it’s so funny to see them reporting that Baltic amber necklaces “really work” for preventing teething issues in babies.

One of the bloggers was sent a necklace by an amber company. She put it on her baby at 3 months of age (too early to teethe). 5 months and 5 teeth later  – no loss of sleep, no cranky baby, no teething problems whatsoever. Hooray! It’s a miracle! In her words: “Baltic amber is a win!” For the moment, let’s gloss over the fact that the necklace was provided free of charge and that the blogger was compensated for her post (ahem, Baltic amber shill).

So let me compare this to my experience. My baby is now 8.5 months old and also has 5 teeth. We’ve had no loss of sleep, no crankiness, no problems whatsoever with teething….and no amber necklace! Hooray! It’s a miracle! Wearing stripy Rainbow Brite-style leggings and pointing excitedly at next door’s dog (my daughter’s current favorite activity) are a win! Or maybe it’s the cucumber that she often eats for dinner! Or the fact that she can see the mountains from her crib! Or… some babies just teethe better than others.

Billions of children have been given vaccines that prevent disease with no ill-effects whatsoever, which the anti-vaccination activists appear to consider irrelevant. Yet one child given an amber necklace, with no control group or latin-square experimental design to test it’s efficacy – it’s a win! Baltic amber works! For goodness sake, try and be consistent MAM – you wouldn’t consider a sample size of one (my daughter for example, who has experienced no adverse effects from vaccines to date) to be proof that vaccines are ok – why do it with other issues that affect children’s health and wellbeing?

I’m not suggesting that teething pain is on the same scale of importance as the provision of vaccines, but let’s be realistic. If you’re going to this site (or others like it) for unbiased, sound information about vaccines or child health, just take a look at the other posts and products that are being promoted. Would I take cardiac advice from a surgeon who offered me three leeches and a tincture of wormwood to cure cancer*? No – and neither should you.

*Or eating tumeric and avoiding wearing a bra to avoid getting breast cancer, as MAM suggests

Who Needs Scientists? Just Let Mother Nature Design Your Greek Yogurt.

Chobani.jpgHow you get to 100 calories matters. Most companies use artificial sweeteners. We think Mother Nature is sweet enough”. Clever marketing from the greek yogurt company Chobani, simultaneously disparaging alternative brands, and playing the ultimate caring, sharing, natural card with the mention of “Mother Nature”. However, earlier this week, Chobani’s #howmatters hashtag set the twitter feeds alight after their new “witty” tagline on the underside of yogurt lids was posted (below).

howmattersThe wording plays beautifully into what is fast becoming a universal fear of science intruding on our food supply – we want real food; food like our grandparents ate; food from traditional breeds and heirloom varieties – providing it doesn’t take us over 2,000 cal per day or increase our cholesterol levels. Rightly or wrongly, many people blame processed foods with hidden sugars and added chemical preservatives for many health issues in developed countries – the epitome of a #firstworldproblem, given that the corresponding #thirdworldproblem is hunger and malnutrition.

However, this time the twitter anger wasn’t from rampaging mommy bloggers, or infuriated activists, but scientists. After all, without science, would Chobani have a product? Yogurt was first developed in ancient times, but the modern pasteurized, long-shelf-life, greek yogurt is rather different to the cultured milk our ancestors would have enjoyed.

FAGEI have a 100-calorie greek yogurt from a rival brand in my fridge, so let’s examine the ingredients (left). Simply pasteurized skimmed milk and live active yogurt cultures (note, no added sweeteners). Louis Pasteur, a 19th century French scientist developed pasteurization (in addition to his discoveries relating to vaccines and microbial fermentation); biologists developed methods to identify and classify the bacteria that ferment milk into yogurt; and food scientists experimented with the exact mixture of bacteria to produce the desired flavor, texture and color of yogurt,  as well as developing the range of other processes needed to make the yogurt safe, appealing and shelf-stable.

Yes, we could make greek yogurt without scientists – after all, the original recipe didn’t originate in a corporate experimental kitchen. But without hundreds of years of scientific input, could we make Greek yogurt that, at 100 calories per serving, is desirable to the consumer and is a safe, affordable source of vitamins, minerals and protein? No. To imply that we could does a huge disservice to food scientists.

It appears that being a modern-day scientist appears to be somewhat equivalent to clubbing baby seals to death. Caring little for human suffering and illness, the cold and clinical scientist rubs his hands together with glee as he removes all nutrients from real food, replacing them with chemicals, additives and genetically-modified ingredients. As a side-line, he develops cocktails of toxic elements, pesticides and embalming fluid and markets them as vaccines. Yes, science is the enemy. Just remember that next time you take an aspirin for a hangover from pasteurized, fermented beverages.